The CDM-Net Project: The Development, Implementation and Evaluation of a Broadband-Based Network for Managing Chronic Disease

Background. In Australia most chronic disease management is funded by Medicare Australia through General Practitioner Management Plans (GPMPs) and Team Care Arrangements (TCAs). Identified barriers may be reduced effectively using a broadband-based network known as the Chronic Disease Management Service (CDMS). Aims. To measure the uptake and adherence to CDMS, test CDMS, and assess the adherence of health providers and patients to GPMPs and TCAs generated through CDMS. Methods. A single cohort before and after study. Results. GPMPs and TCAs increased. There was no change to prescribed medicines or psychological quality of life. Attendance at allied health professionals increased, but decreased at pharmacies. Overall satisfaction with CDMS was high among GPs, allied health professionals, and patients. Conclusion. This study demonstrates proof of concept, but replication or continuation of the study is desirable to enable the impact of CDMS on diabetes outcomes to be determined.

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Factors Affecting Customer Intention to Adopt a Mobile Chronic Disease Management Service

Journal of Organizational and End User Computing ◽

10.4018/joeuc.287910 ◽

2022 ◽

Vol 34 (4) ◽

pp. 1-23

Author(s):

Zhangxiang Zhu ◽

Yongmei Liu ◽

Xianye Cao ◽

Wei Dong

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Chronic Disease Management ◽

Age Groups ◽

The Elderly ◽

Young Group ◽

Limited Attention ◽

Management Service ◽

Intention To Adopt ◽

The Impact

The Mobile Chronic Disease Management Service (MCDMS) is an emerging medical service for chronic disease prevention and treatment, but limited attention has been paid to the factors that affect users’ intention to adopt the service. Based on the unified theory of acceptance and use of technology 2 and the protection motivation theory, the authors built an MCDMS adoption model. The authors also verified the differentiating age effect on the service adoption intention from experiential distance perspective of the construal level theory. Empirical results showed that the young group focused more on the impact of effort expectancy, whereas the elderly group focused more on performance expectancy, imitating others, and perceived severity. Furthermore, the young group, however, focused more on the impact of perceived vulnerability, and offline medical habits showed no significant influence on either group’s intention to adopt, which were not consistent with the original hypotheses. The findings can aid MCDMS providers in selecting marketing strategies targeted toward different age groups.

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Investing in big ideas: utilisation and cost of Medicare Allied Health services in Australia under the Chronic Disease Management initiative in primary care

Australian Health Review ◽

10.1071/ah10938 ◽

2011 ◽

Vol 35 (4) ◽

pp. 468 ◽

Cited By ~ 23

Author(s):

Robyn P. Cant ◽

Michele M. Foster

Keyword(s):

Chronic Disease ◽

General Practitioner ◽

Disease Management ◽

Health Services ◽

Allied Health ◽

Chronic Disease Management ◽

Management Program ◽

Care Planning ◽

Health Providers ◽

Per Capita

Objective. To critically examine utilisation of the 13 allied health services provided through Medicare Chronic Disease Management program and related general practitioner (GP) care planning initiatives. Methods. Statistics generated from national billing data from July 2005 to June 2009 were extracted from Medicare data and compared by profession, State or Territory and population. Results. Most services grew over 4 years although nationally consistent service levels were not found for any allied health provider profession. On referral from GPs, podiatry, physiotherapy and dietetics provided most services (82%) in 2008–09. Professions had unique patterns of referral instanced by age range and sex of clientele. Wide variation was apparent in per capita utilisation of allied health services by State or Territory; some with far less than average national use and others with high use. Annual number of GP Management Plans or Team Care Arrangements was low (mean: ≤22 per GP in 2008–09), indicating low use of care planning. Conclusion. Inequality of accessibility for patients was apparent. Five years into the program, a review of Medicare Allied Health CDM policy is warranted. Implications. Research and evaluation is needed to identify whether the program is meeting the needs of GPs, allied health providers and chronic disease patients. What is known about the topic? Since 2004, Medicare Chronic Disease Management program has offered Australian patients with chronic or complex disease access to 13 allied health professions via private clinics on referral from their general practitioner – with costs subsidised by Medicare. Little is known about the demographics of referred patients or which allied health services are utilised. What does this paper add? We take a multidisciplinary perspective to describe program use and find wide variation by profession nationally. Per capita State and Territory data indicate inequality of accessibility. Podiatry, physiotherapy and dietetics provided 82% of all services in 2008–09. Referrals initiated by GPs via patient care plans are increasing, but at present referrals per each GP are low. What are the implications for practitioners? More needs to be known about the dynamics that affect referral, the local accessibility of allied health providers and issues that affect uptake by patients.

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Importance of safety climate, teamwork climate and demographics: understanding nurses, allied health professionals and clerical staff perceptions of patient safety

BMJ Open Quality ◽

10.1136/bmjoq-2018-000433 ◽

2018 ◽

Vol 7 (4) ◽

pp. e000433

Author(s):

Shahram Zaheer ◽

Liane R Ginsburg ◽

Hannah J Wong ◽

Kelly Thomson ◽

Lorna Bain

Keyword(s):

Patient Safety ◽

Health Professionals ◽

Allied Health ◽

Safety Climate ◽

Outcome Variable ◽

Senior Leadership ◽

Staff Perceptions ◽

Allied Health Professionals ◽

Leadership Support ◽

The Impact

BackgroundThere is growing evidence regarding the importance of contextual factors for patient/staff outcomes and the likelihood of successfully implementing safety improvement interventions such as checklists; however, certain literature gaps still remain—for example, lack of research examining the interactive effects of safety constructs on outcomes. This study has addressed some of these gaps, together with adding to our understanding of how context influences safety.PurposeThe impact of staff perceptions of safety climate (ie, senior and supervisory leadership support for safety) and teamwork climate on a self-reported safety outcome (ie, overall perceptions of patient safety (PS)) were examined at a hospital in Southern Ontario.MethodsCross-sectional survey data were collected from nurses, allied health professionals and unit clerks working on intensive care, general medicine, mental health or emergency department.ResultsHierarchical regression analyses showed that perceptions of senior leadership (p<0.001) and teamwork (p<0.001) were significantly associated with overall perceptions of PS. A non-significant association was found between perceptions of supervisory leadership and the outcome variable. However, when staff perceived poorer senior leadership support for safety, the positive effect of supervisory leadership on overall perceptions of PS became significantly stronger (p<0.05).Practice implicationsOur results suggest that leadership support at one level (ie, supervisory) can substitute for the absence of leadership support for safety at another level (ie, senior level). While healthcare organisations should recruit into leadership roles and retain individuals who prioritise safety and possess adequate relational competencies, the field would now benefit from evidence regarding how to build leadership support for PS. Also, it is important to provide on-site workshops on topics (eg, conflict management) that can strengthen working relationships across professional and unit boundaries.

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Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes

JMIR mhealth and uhealth ◽

10.2196/15927 ◽

2020 ◽

Vol 8 (3) ◽

pp. e15927

Author(s):

Scott Sittig ◽

Jing Wang ◽

Sriram Iyengar ◽

Sahiti Myneni ◽

Amy Franklin

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Mobile Health ◽

Self Efficacy ◽

Chronic Disease Management ◽

Text Messages ◽

Feasibility Trial ◽

Significant Difference ◽

Within Subjects ◽

The Impact

Background Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. Objective The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. Methods The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample t test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. Results Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: P=.03; exercise: P=.005; and blood glucose: P=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (P=.008) and exercise (P=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. Conclusions Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. Trial Registration ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089

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Amended ID: 40. An integrative review evaluating the competence, knowledge or skills of allied health professionals in providing nutrition care to patients with chronic disease.

10.26226/morressier.60b65c8a85c68bde00a3575f ◽

2021 ◽

Author(s):

Megan Keane

Keyword(s):

Chronic Disease ◽

Health Professionals ◽

Allied Health ◽

Integrative Review ◽

Allied Health Professionals ◽

Nutrition Care

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Impact of COVID-19 on chronic disease management

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213110 ◽

2021 ◽

Vol 9 (8) ◽

pp. 2510

Author(s):

Srikar Sama ◽

Alekhya Gajjala

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Chronic Disease ◽

Kidney Disease ◽

Disease Management ◽

Chronic Disease Management ◽

Routine Care ◽

Review Article ◽

Potential Impact ◽

The Impact

Routine care for chronic disease is an ongoing major challenge. We aimed to evaluate the impact of COVID-19 on routine care for chronic diseases. A deeper understanding helps to increase the health system’s resilience and adequately prepare for the next waves of the pandemic. Diabetes, heart failure, chronic kidney disease, and hypertension were the most impacted conditions due to the reduction in access to care. It is important routine care continues in spite of the pandemic, to avoid a rise in non-COVID-19-related morbidity and mortality. This is a review article discussing the potential impact of COVID-19 on chronic disease management.

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Mid-level health providers for primary healthcare: a rapid evidence synthesis

F1000Research ◽

10.12688/f1000research.24279.2 ◽

2021 ◽

Vol 9 ◽

pp. 616

Author(s):

Sandeep Moola ◽

Soumyadeep Bhaumik ◽

Devaki Nambiar

Keyword(s):

Chronic Disease ◽

Antiretroviral Therapy ◽

Disease Management ◽

Systematic Reviews ◽

Methodological Quality ◽

Chronic Disease Management ◽

Health Providers ◽

Pregnancy Care ◽

Review Team ◽

Quality Evidence

Background: Healthcare services, in many countries, are increasingly being provided by cadres not trained as physicians, and these substitute health workers are referred to as mid-level health providers (MLHPs). The objective of this study was to rapidly synthesise evidence on the effectiveness of MLHPs involved in the delivery of healthcare, with a perspective on low- and middle-income countries. Methods: The review team performed an overview of systematic reviews assessing various outcomes for participants receiving care from MLHPs. The team evaluated systematic reviews for methodological quality and certainty of the evidence. Also, the review team consulted relevant stakeholders in India. Results: The final report included seven systematic reviews, with six assessed as moderate to high methodological quality. Mortality outcomes concerning pregnancy and childbirth care services showed no significant differences in care provided by MLHPs when compared with doctors. Pregnancy care provided by midwives was found to improve the quality of care slightly. The risk of failure or incomplete abortion for surgical abortion procedures provided by MLHPs was twice when compared to the procedures provided by doctors. Moderate to high certainty evidence showed that initiation and maintenance of antiretroviral therapy for HIV-infected patients by a nurse or clinical officer slightly reduced mortality. High certainty evidence showed that chronic disease management by non-medical prescribers reduced some important physiological measures compared to medical prescribing by doctors. Conclusions: To date, this is the first rapid overview of the evidence on MLHPs. Low-quality evidence suggests that MLHPs might be suitable to deliver quality pregnancy care. Moderate and high-quality evidence from trials suggests that MLHPs are helpful for chronic disease management and initiation and maintenance of antiretroviral therapy in people with HIV/AIDS. However, the roles and subsequent training and regulation of MLHPs might be different for different care domains.

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The Use and Evaluations of IT in Chronic Disease Management

Clinical Technologies ◽

10.4018/978-1-60960-561-2.ch406 ◽

2011 ◽

pp. 1075-1092

Author(s):

Julia Adler-Milstein ◽

Ariel Linden

Keyword(s):

Information Technology ◽

Chronic Disease ◽

Disease Management ◽

Information Technologies ◽

Chronic Disease Management ◽

Program Effectiveness ◽

Management Program ◽

Evaluation Strategies ◽

Broad Array ◽

The Impact

This chapter describes the broad array of information technologies currently used in programs that manage individuals with chronic diseases and discusses evaluation strategies to assess the impact of implementing programs that incorporate such technologies. More specifically, it describes the three components of a chronic disease management program and then details the technologies commonly used in each component. Three evaluation designs well-suited to measure DM program effectiveness are also discussed. The intent of this chapter is to educate readers on the range of approaches to incorporating information technology into chronic disease management and the most appropriate evaluation designs that will strengthen the understanding of which approaches are most successful.

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